Provider Demographics
NPI:1154440428
Name:GACKA, NATALIE (CRNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:GACKA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9639
Mailing Address - Country:US
Mailing Address - Phone:724-449-9300
Mailing Address - Fax:724-449-2770
Practice Address - Street 1:5321 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9639
Practice Address - Country:US
Practice Address - Phone:724-449-9300
Practice Address - Fax:724-449-2770
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008322363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics